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Article

Efflux Pump-Driven Antibiotic and Biocide Cross-Resistance in Pseudomonas aeruginosa Isolated from Different Ecological Niches: A Case Study in the Development of Multidrug Resistance in Environmental Hotspots

1
UniSA Clinical and Health Sciences, Health and Biomedical Innovation, University of South Australia, Adelaide, SA 5000, Australia
2
Department of Medical Microbiology, University of Gondar, Gondar 196, Ethiopia
3
Future Industries Institute, University of South Australia, Mawson Lakes, SA 5095, Australia
4
EUCAST Development Laboratory, Adelaide Medical School, University of Adelaide, Adelaide, SA 5000, Australia
5
Microbiology and Infectious Diseases, SA Pathology, Adelaide, SA 5000, Australia
*
Author to whom correspondence should be addressed.
Microorganisms 2020, 8(11), 1647; https://doi.org/10.3390/microorganisms8111647
Received: 23 September 2020 / Revised: 16 October 2020 / Accepted: 19 October 2020 / Published: 24 October 2020
(This article belongs to the Special Issue Breaking the Code of Antibiotic Resistance)
Pseudomonas aeruginosa is an opportunistic pathogen displaying high intrinsic antimicrobial resistance and the ability to thrive in different ecological environments. In this study, the ability of P. aeruginosa to develop simultaneous resistance to multiple antibiotics and disinfectants in different natural niches were investigated using strains collected from clinical samples, veterinary samples, and wastewater. The correlation between biocide and antimicrobial resistance was determined by employing principal component analysis. Molecular mechanisms linking biocide and antimicrobial resistance were interrogated by determining gene expression using RT-qPCR and identifying a potential genetic determinant for co- and cross-resistance using whole-genome sequencing. A subpopulation of P. aeruginosa isolates belonging to three sequence types was resistant against the common preservative benzalkonium chloride and showed cross-resistance to fluoroquinolones, cephalosporins, aminoglycosides, and multidrug resistance. Of these, the epidemiological high-risk ST235 clone was the most abundant. The overexpression of the MexAB-OprM drug efflux pump resulting from amino acid mutations in regulators MexR, NalC, or NalD was the major contributing factor for cross-resistance that could be reversed by an efflux pump inhibitor. This is the first comparison of antibiotic-biocide cross-resistance in samples isolated from different ecological niches and serves as a confirmation of laboratory-based studies on biocide adapted isolates. The isolates from wastewater had a higher incidence of multidrug resistance and biocide-antibiotic cross-resistance than those from clinical and veterinary settings. View Full-Text
Keywords: antimicrobial resistance; biocide resistance; efflux pump; Pseudomonas aeruginosa; cross-resistance; resistance development; selective pressure antimicrobial resistance; biocide resistance; efflux pump; Pseudomonas aeruginosa; cross-resistance; resistance development; selective pressure
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MDPI and ACS Style

Amsalu, A.; Sapula, S.A.; De Barros Lopes, M.; Hart, B.J.; Nguyen, A.H.; Drigo, B.; Turnidge, J.; Leong, L.E.; Venter, H. Efflux Pump-Driven Antibiotic and Biocide Cross-Resistance in Pseudomonas aeruginosa Isolated from Different Ecological Niches: A Case Study in the Development of Multidrug Resistance in Environmental Hotspots. Microorganisms 2020, 8, 1647. https://doi.org/10.3390/microorganisms8111647

AMA Style

Amsalu A, Sapula SA, De Barros Lopes M, Hart BJ, Nguyen AH, Drigo B, Turnidge J, Leong LE, Venter H. Efflux Pump-Driven Antibiotic and Biocide Cross-Resistance in Pseudomonas aeruginosa Isolated from Different Ecological Niches: A Case Study in the Development of Multidrug Resistance in Environmental Hotspots. Microorganisms. 2020; 8(11):1647. https://doi.org/10.3390/microorganisms8111647

Chicago/Turabian Style

Amsalu, Anteneh, Sylvia A. Sapula, Miguel De Barros Lopes, Bradley J. Hart, Anh H. Nguyen, Barbara Drigo, John Turnidge, Lex E. Leong, and Henrietta Venter. 2020. "Efflux Pump-Driven Antibiotic and Biocide Cross-Resistance in Pseudomonas aeruginosa Isolated from Different Ecological Niches: A Case Study in the Development of Multidrug Resistance in Environmental Hotspots" Microorganisms 8, no. 11: 1647. https://doi.org/10.3390/microorganisms8111647

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